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Individual

GREGORY DEAN WALTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
801 POLE LINE ROAD WEST, TWIN FALLS, ID 83301-5799
(208) 814-1000
(208) 814-0948
Mailing address
801 POLE LINE ROAD WEST, TWIN FALLS, ID 83301-5799
(208) 814-1000
(208) 814-0948

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA799A
ID

Other

Enumeration date
07/18/2011
Last updated
07/18/2011
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